Posts Tagged ‘fracture’

Thought you were safe from osteoporosis because you’re a guy? Think again. Osteoporosis is not just a women’s disease. In fact, one in eight males will develop an osteoporosis-related fracture in his lifetime.

When you’re young, your bone is constantly changing—old bone is removed and replaced by new bone. Osteoporosis occurs when new bone is not generated quickly enough to replace old bone, leading to decreased bone mass and a weakened skeleton. This weakening, in turn, leads to an increased susceptibility to fractures. While more women than men develop osteoporosis, according to the National Institutes of Health (NIH), it still poses a significant threat to millions of men in the U.S.

Why do fewer men than women develop the disease? Men have larger skeletons—meaning more overall bone mass—and don’t undergo the same bone-loss-causing hormone changes that women deal with during menopause. Bone loss in men starts later and progresses more slowly. However, because men are living longer these days, osteoporosis has become an important public health issue.

While osteoporosis in women is generally age related, most men develop the disease for different reasons. Some of the risk factors that have been linked to osteoporosis in men include:

A “silent disease,” osteoporosis progresses without symptoms until a fracture occurs. Those fractures most often are in the hip, spine, and wrist and can be permanently disabling. Hip fractures, in particular, are dangerous, as men who sustain hip fractures are more likely than women to die from complications.

In men, all too often osteoporosis isn’t diagnosed until a fracture occurs. If you have any of the lifestyle risk factors for developing the disease, or you experience a loss of height or change in posture, a fracture, or sudden back pain, tell your doctor. When detected before significant bone loss has occurred, osteoporosis can be treated with medication, improved nutrition, exercise, and lifestyle changes. If you think you may be at risk for osteoporosis, make an appointment with your Emory physician for a medical workup and bone mineral density test.

Do you have osteoporosis, or do you know someone who does? How are you dealing with it? We welcome your questions and feedback in the comments section below.

A couple of years ago, a young recruit of the Atlanta Falcons football team was running during practice when his cleat got caught in the turf, a misstep that led to him both twisting and breaking his foot. The injury turned out to be what’s known as a “Jones fracture,” which is a very specific break in one of the bones in the midportion of the foot.

The Falcons recruit went out of state for surgery to insert a screw in his foot that would secure the bone while it healed, but his injury never healed properly, and on the first day of football practice the next year, he rebroke his foot. This time, he decided to find a surgeon in the Atlanta area and was referred to Dr. Sam Labib, director of the foot and ankle service at the Emory Sports Medicine Center.

During his time practicing at Emory, Dr. Labib has become very familiar with the Jones fracture. “As it turned out, at Emory, we had done extensive anatomic research on this particular type of injury and knew the ideal location for the screw,” he says. “When he came in for surgery, we removed the screw, cleaned up the bone, and replaced the screw in a better, more stable area.”

“Because we are a research environment as well as a surgical practice, we have a wealth of information and experience to bring to bear on injuries such as the Jones fracture,” Dr. Labib says. “Doing anatomic research is like drawing a map for surgery. With practice, we can effectively calculate the path of the screw and place it in the most solid position. Our patients benefit from this research and expertise.”

According to Dr. Labib, a Jones fracture typically takes a minimum of three months to heal. In the football player’s case, the fracture healed beautifully after his surgery at Emory, and he was back to training just three months later.

Have you had foot surgery, or would you like to learn more about foot surgery at Emory? We welcome your questions and feedback for Dr. Labib in the comments section below.

At Emory Healthcare, we’re always looking for new and better ways to treat patients. Bone healing, particularly after spine fusion surgery, is one of the many areas in which we’ve pioneered research that can significantly improve our patients’ quality of life. For more than two decades, the Emory Orthopaedics & Spine Center has been instrumental in developing technology to improve bone healing, accelerate the speed of healing, and prevent the need to “borrow” bone graft.

While some broken bones heal quickly and easily, certain types of leg bone fractures and high energy traumatic fractures often need extra help. In some cases, bone graft has been used in the treatment of difficult fractures, segmental bone loss, and fusion of other joints in the body that may have severe arthritis (e.g., foot joints). At Emory, spine fusion represents 50% of the reason our surgeons would harvest bone graft in the past. Many spine operations involve getting bone to grow in the spine, where it normally doesn’t grow. Also, for certain types of long spine fusions, there’s often not enough bone. Traditionally, the surgeon would harvest bone graft from the patient’s hip (pelvis). This process, called an iliac crest bone graft harvest, often causes patients to complain of chronic pain at the bone donor site.

So how do we accelerate bone healing and avoid the use of bone graft? Emory has participated in laboratory studies and clinical trials to work out the details of how to use special proteins in humans. The first procedure was approved by the FDA in 2002. The approval is for only very specific indications, so work is ongoing to optimize these proteins for more broad use. Since we at Emory are very familiar with the science and development of these proteins, we’re able to use them safely in a variety of individual patient cases. In some situations, use of these proteins can prevent the need for bone graft harvest from the hip and result in better healing.

Some of the newer bone-healing technologies have only limited approval by the FDA and can be associated with some local side effects, so their use is not as broad unless they are being used by a very experienced surgeon or as part of a research trial—such as those conducted at Emory. Over the next five to 10 years, you can expect these new bone healing technologies to be more commonly used. If you’re having surgery at Emory that requires bone grafting or bone healing, ask your surgeon whether bone healing technology is a viable option for you.

Have you had a bone graft or surgery using new bone-healing technology? We welcome your questions and feedback about accelerated bone healing in the comments section below. For more information on accelerated bone healing technology at Emory, watch the short video below:

About Dr. Boden

Scott D. Boden, MD, Director of the Emory Orthopaedics & Spine Center and Professor of Orthopaedic Surgery, is an internationally renowned surgeon, lecturer, and teacher and the driving force behind the Emory University Orthopedics and Spine Hospital (EUOSH). Dr. Boden started practicing at Emory in 1992.

When you injure your ankle, it may be hard to tell whether you’ve sprained it (stretched or torn a tendon or ligament) or fractured it (broken a bone). Generally speaking, here are some things to keep in mind:

If you have pain around the soft tissue areas but not over the bone, you probably have a sprain, not a break.

If you have pain over the ankle bone, you most likely have a break.

If you’re not able to walk on it, there’s a good chance you have a break.

If you’ve hurt your ankle but you’re not sure it’s serious, a general rule of thumb is to watch it for two to four days and use the RICE method—REST your ankle, put an ICE pack on it, use COMPRESSION, such as an Ace bandage or air cast (available at your local drugstore) to stabilize it, and ELEVATE it. If, after two to four days, you still have significant pain or difficulty putting weight on your foot, or you see black and blue marks or blisters, it’s time to see a doctor.

At the Emory Orthopaedics & Spine Center, our orthopedic specialists are experts at diagnosing and treating foot and ankle injuries. We use our clinical knowledge, an MRI when needed (we have the only 3-tesla MRI in the state—think of it as an MRI in HD), and X-rays to help determine whether you’ve fractured a bone or torn a ligament and whether the injury requires surgery. Most ankle injuries, whether fractures or sprains, can be treated conservatively, without surgery. However, if a fracture calls for surgery, we may use a plate and screws on the side of the bone or a screw or rod inside the bone to realign the bone fragments and stabilize them as they heal. Sometimes a soft tissue injury will require surgical intervention, as well, as it may create ankle instability and need to be repaired. However, most cases will do well with conservative care and physical therapy to follow.

When you see your doctor after an ankle injury, it’s important to describe in detail how the injury occurred. Did your foot turn under, out, in, or rotate? The more you can tell us, the more effectively we’ll be able to diagnose and treat your injury. Any information you can tell us is useful. At Emory Orthopaedics & Spine Center, we focus on listening to the patient and tailoring a treatment plan that fits the patient, without compromising care or adequate healing time.

If you’ve sprained your ankle in the past and now find that it twists easily or feels weak, you may have damaged the ligaments, causing chronic ankle instability. Although you may not feel any pain originally, over time you may develop arthritis in your ankle. At Emory, we can try to implement physical therapy for ankle strengthening, but if that fails, it may be necessary to repair the ligaments so that your ankle is stabilized.

Remember—if your ankle hurts, don’t push it. There’s a reason your body is talking to you, so get it looked at by a doctor. Our goal is to keep you active for the long term not just the short term. The worst thing you can do is to try to push through the pain and ignore your body’s communication, as that may lead to long-term ankle joint disability and arthritis. It’s not uncommon for an ankle sprain to be painful for many months after an injury, and swelling may last for four months to a year, but if it still hurts to put weight on it two to three weeks after you’ve injured it, make an appointment at the Emory Orthopaedics & Spine Center to see a foot and ankle specialist.

Have you sprained or broken your ankle? Have you had an ankle injury that required surgery? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

About Rami Calis, DPM:

Rami Calis, DPM, is assistant professor in the Department of Orthopedics. He is board certified and a Diplomate, American Board of Podiatric Orthopedics and Primary Podiatric Medicine, with an interest in sports medicine of the lower extremity and foot and ankle biomechanics. Dr. Calis holds clinic and does surgery at Emory Orthopaedics & Spine Center at Executive Park and also holds clinic in Duluth, at our satellite office. Dr. Calis’ professional goal is to improve patient care and quality of life for patients with foot and ankle problems. Dr. Calis began practicing at Emory in 2003.

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